食积与湿
散郁开痰 橘半、枳术丸、三棱丸。
宣 见心痛萝卜法。
导滞 轻者,枳、丸、茱连丸、陷胸汤。又煮虾蟆,食法见前鼓胀例下。
多是痰、食郁。有热,姜炒黄连不可无。
脱精,专主湿热、虚。
固真 缚虎饮子,见腰痛补例。
补 气血虚,与八物汤下珍珠粉丸。
燥湿 珍珠粉丸方∶黄柏、知母、牡蛎粉、蛤粉。
清热安神 青黛、海石、柏。
灸
湿热、痰、虚。赤属血,白属气。
燥湿 湿痰流注,于二陈中加仙术、白术。赤者加白芍,仍用珍珠粉丸。
清热 脉弦滑者,青黛、滑石、柏、□。
燥痿 南星,守田,海石,以神曲糊为丸,青黛衣。
补 气血虚,缚虎饮子下珍珠丸。心虚,宜定志丸。
下 热在下,气实者,导水丸。
大率行痰为主。
清热养气血 宁神丹∶
天麻 人参 陈皮 白术 归身 茯神 荆穗 僵蚕 独活 远志 犀角 麦门冬 枣
仁
辰砂(各五钱) 守田 南星 石膏(各一两) 甘草 白附子 川芎 郁金 牛黄(各三钱)
珍珠(三钱) 生地 黄连(各半两) 金箔(三十片) 共为末,酒糊为丸。
灸 百会、鸠尾、上脘、神门。
食积与湿邪
疏散郁结、开泄痰浊:使用橘红、半夏,以及枳术丸、三棱丸。
宣通:参见心痛篇中萝卜法。
导滞:病情轻者,使用枳实、丸剂(指前述方剂)、吴茱萸黄连丸、陷胸汤。另外煮食蛤蟆,食用方法见前文鼓胀病例之下。
胃中有火邪、痰浊、气机郁滞、食积停滞,根据具体证候进行治疗。
有热邪者,必须顺应其性质而折服它,使用吴茱萸、黄连。湿邪偏胜者,使用七香丸。
多数情况是痰浊、食积郁结。如果有热邪,姜汁炒制的黄连不可不用。
脱精(精气耗损),主要主治湿热、虚证。
固本培元:使用缚虎饮子,见于腰痛补益病例。
补益:气血虚弱者,配合八物汤送服珍珠粉丸。
燥湿:珍珠粉丸方组成:黄柏、知母、牡蛎粉、蛤粉。
清热安神:青黛、海浮石、柏子仁。
艾灸
湿热、痰浊、虚证。赤色属血分,白色属气分。
燥湿:湿痰流注,在二陈汤中加入苍术、白术。赤色者加入白芍,仍使用珍珠粉丸。
清热:脉象弦滑者,使用青黛、滑石、柏子仁、[缺字]。
燥痿(治疗痿痹):天南星、守田(即远志)、海浮石,以神曲糊为丸,用青黛为衣。
补益:气血虚弱者,配合缚虎饮子送服珍珠丸。心气虚弱者,宜用定志丸。
攻下:热邪在下焦,气实者,使用导水丸。
大体上以行痰为主。
清热、滋养气血、宁神:宁神丹方组成:
天麻、人参、陈皮、白术、当归身、茯神、荆芥穗、僵蚕、独活、远志、犀角、麦门冬、酸枣仁(各五钱);
辰砂、守田(远志)、天南星、石膏(各一两);
甘草、白附子、川芎、郁金、牛黄(各三钱);
珍珠(三钱);
生地、黄连(各半两);
金箔(三十片)。
共研为细末,用酒糊制作成丸剂。
艾灸穴位:百会、鸠尾、上脘、神门。
Food Stagnation and Dampness
Disperse depression and open phlegm: Use Chenpi (Citrus reticulata Pericarpium), Banxia (Pinelliae Rhizoma), Zhizhu Wan (Atractylodis Macrocephalae Pill), and Sanleng Wan (Sparganii Pill).
Ventilate: See the Radish Method in the section on Heart Pain.
Guide out stagnation: For mild cases, use Zhishi (Immature Bitter Orange), pills (referring to aforementioned formulas), Wuzhuyu Lianlian Wan (Evodiae et Coptidis Pill), and Xiongtang Decoction. Alternatively, boil and eat a toad; see the dietary method under the previous case of abdominal distension.
When there is fire, phlegm, qi depression, and stagnation in the stomach, treat according to the specific syndrome.
For those with heat, one must follow its nature to subdue it, using Wuzhuyu (Evodiae Fructus) and Huanglian (Coptidis Rhizoma). For those with excessive dampness, use Qixiang Wan (Seven Fragrances Pill).
Most cases involve depression of phlegm and food. If there is heat, Jiangchao Huanglian (Ginger-fried Coptidis Rhizoma) is indispensable.
Jing loss (Essence depletion): Primarily addresses damp-heat and deficiency.
Secure the true essence: Use Fuhu Yinzi (Tiger-Tying Decoction), see the supplementation example for lower back pain.
Tonify: For qi and blood deficiency, administer Zhenzhu Fen Wan (Pearl Powder Pill) with Bajia Tang (Eight Substances Decoction).
Dry dampness: Formula for Zhenzhu Fen Wan (Pearl Powder Pill): Huangbai (Phellodendri Cortex), Zhimu (Anemarrhenae Rhizoma), Muli Fen (Ostreae Concha Pulvis), Ge Fen (Margaritifera Ostreum Pulvis).
Clear heat and calm the spirit: Qingdai (Indigo Naturalis), Haishi (Pterocarpus Santalinus / Floating Stone), Baizi Ren (Platycladi Semen).
Moxibustion
Damp-heat, phlegm, and deficiency. Red indicates blood involvement, white indicates qi involvement.
Dry dampness: For wet-phlegm flowing and accumulating, add Cangzhu (Atractylodis Rhizoma) and Baizhu (Atractylodis Macrocephalae Rhizoma) to Erchen Tang (Two Aged Substances Decoction). For red cases, add Baishao (Paeoniae Radix Alba), and still use Zhenzhu Fen Wan (Pearl Powder Pill).
Clear heat: For wiry and slippery pulses, use Qingdai (Indigo Naturalis), Huashi (Talcum), Baizi Ren (Platycladi Semen), [missing character].
Dry atrophy/impotence: Nanting (Arisaematis Rhizoma), Shoutian (Polygalae Radix / Yuanzhi), Haishi (Floating Stone), made into pills with Shenqu (Massa Medicata Fermentata) paste, coated with Qingdai (Indigo Naturalis).
Tonify: For qi and blood deficiency, administer Zhenzhu Wan (Pearl Pill) with Fuhu Yinzi (Tiger-Tying Decoction). For heart deficiency, Dingzhi Wan (Stabilizing Spirit Pill) is suitable.
Purge: For heat in the lower jiao and excess qi, use Daoshui Wan (Water-Guiding Pill).
Generally, moving phlegm is the primary approach.
Clear heat, nourish qi and blood, calm the spirit: Ningshen Dan (Spirit-Calming Elixir) formula:
Tianma (Gastrodiae Rhizoma), Renshen (Ginseng Radix et Rhizoma), Chenpi (Citri Reticulatae Pericarpium), Baizhu (Atractylodis Macrocephalae Rhizoma), Guishen (Angelicae Sinensis Radix), Fushen (Poria with Hostwood), Jing Sui (Schizonepetae Spica), Jiangcan (Bombyx Batryticatus), Duhuo (Angelicae Pubescentis Radix), Yuanzhi (Polygalae Radix), Xi Jiao (Rhinocerotis Cornu), Maidong (Ophiopogonis Tuber), Zaoren (Ziziphi Spinosae Semen) (each 5 qian);
Chensha (Cinnabaris), Shoutian (Polygalae Radix), Nanting (Arisaematis Rhizoma), Shigao (Gypsum Fibrosum) (each 1 liang);
Gancao (Glycyrrhizae Radix et Rhizoma), Baifuzi (Aconiti Kusnezoffii Radix Praeparata), Chuanxiong (Ligustici Chuanxiong Rhizoma), Yujin (Curcumae Longae Radix), Niuhuang (Calculus Bovis) (each 3 qian);
Zhenzhu (Margarita) (3 qian);
Shengdi (Rehmanniae Radix), Huanglian (Coptidis Rhizoma) (each half liang);
Jinbo (Folium Aureum) (30 pieces).
Grind all into fine powder, make pills with wine paste.
Moxibustion acupoints: Baihui (GV20), Jiutui (CV15), Shangwan (CV13), Shenmen (HT7).